Conventional interferon alfa-2b and ribavirin for 12 versus 24 weeks in HCV genotype 2 or 3

To determine the efficacy of 12 weeks therapy with conventional interferon and ribavirin in chronic hepatitis C genotype 2 and 3 naive patients.

A randomized clinical trial.

Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, from January 2005 to October 2006.

Two hundred and twenty seven patients with chronic hepatitis C genotype 2 or 3 naive patients were enrolled in the study. All the patients were started on conventional Interferon 3 MIU, S/C, three times a week plus Ribavirin 800 to 1200 mg in divided doses daily. HCV-RNA qualitative PCR was determined after 4 weeks. In case of undetected PCR, patients were randomized to Group-I (where antiviral therapy was given for 12 weeks, n=81) or Group-II (where antiviral therapy was given for 24 weeks, n=81). In case of detected PCR, patients were given 24 weeks antiviral therapy, n=65 (Group-III). HCV-RNA PCR was determined at the end of respective therapies and after 6 months later on. Efficacy was defined as number of patients who achieved Sustained Virological Response (SVR) i.e. HCV-RNA PCR remained undetected 6 months after the end of antiviral therapy.

SVR was achieved in 66 patients (81.48%) in Group-I, 64 patients (79.01%) in Group-II, and 49 patients (75.35%) in Group-III. SVR rate was better in genotype 2 than genotype 3 in all the three groups (p=0.031, OR = 1.52).

Conventional Interferon and Ribavirin combination therapy remains an effective therapy in chronic hepatitis genotype 2 and 3 naive patients in our region. Determination of HCV-RNA qualitative PCR at 4 weeks seems to be an important predictor of SVR and should be used to tailor antiviral therapy to 12 or 24 weeks.